1. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Comparison of Pharmacology and Toxicology This material was developed at the Environmental Health Education Center of the University of Maryland School of Nursing. For more information, see envirn.umaryland.edu

2. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Objectives  By the end of this class, students will be able to: Define toxicology Discuss 8 concepts of toxicology that are important in understanding and evaluating environmental health issues Compare and contrast the key concepts of environmental toxicology with concepts of pharmacology

3. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Definitions  Pharmacology: the scientific study of the origin, nature, chemistry, effects, and use of drugs  Toxicology: the science that investigates the adverse effects of chemicals on health.

4. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Dose  Pharmacology: Dose refers to the amount of a drug absorbed from an administration.  Toxicology: Dose refers to the amount of a chemical absorbed into the body from an exposure.

5. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Key Factors Related to Dose  In pharmacology, we have good control over who receives what dosage of what substance.  In environmental health, it is usually difficult to control or determine who receives what dose of which toxin(s).

6. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Administration/Exposure  Pharmacology: Administration regimen: A drug can be administered one time, short-term, or long-term.  Toxicology: Exposure is the actual contact that a person has with a chemical. It can be one-time, short-term, or long-term.

7. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Key Factors Related to Administration/Exposure  Drugs are taken voluntarily.  Hazardous chemical exposures are often involuntary.  With both drugs and hazardous chemicals, children’s behavior entails special exposure risks.

8. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Routes of Administration/Exposure  Pharmacology: Routes of administration: oral, IM, IV, subcutaneous, topical  Toxicology: Routes of exposure: ingestion, inhalation, dermal, conjunctival

9. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Key Factors Related to Routes of Administration/Exposure  In administration of medication, different routes are used based upon the efficacy of absorption of drugs from each route.  In environmental health, different toxins are absorbed through different routes of exposure, which results in variations in toxicity.

10. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Distribution, Metabolism and Excretion  Pharmacology and Toxicology: Distribution, metabolism and excretion describe what happens to the drug or toxin in the body. Distribution: organs that are reached Metabolism: chemical transformation metabolites Excretion: elimination.

11. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Dose-Response Curve  Pharmacology: Dose-response curve graphically represents the relationship between the dose of a drug and the response elicited

12. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Dose-Response Curve  Toxicology: Dose-response curve describes the relationship of the body’s response to different amounts of an agent

13. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Key Factors Related to Dose Response  The dose-response curve may differ for different populations.  Individuals vary with regard to response to drugs or toxins.

14. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Responses - Pharmacology  Pharmacology: Low dose no observable response (subtherapeutic) dose therapeutic response (and side effects) > therapeutic dose toxicity

15. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Responses - Toxicology  Toxicology: Only toxic effects are of concern. Low doses NOEL (no observable effect level) > NOEL toxicity

16. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Toxicity Toxicity is the ability of a chemical to damage an organ system, to disrupt a biochemical process, or to disturb an enzyme system.

17. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Key Factors Related to Toxicity  With medications, side effects sometimes result from long-term use of the drug.  In environmental health, chronic exposure may result in effects that are quite different from the effects of single larger exposures.

18. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Interactions  Pharmacology: Drug interactions define the effect one drug has on another.  Toxicology: Toxicological interactions define the effect one chemical has on another.

19. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Interactions, continued  3 types of effects: Additive: the sum = the whole Synergistic or potentiated: one enhances the other’s effect Antagonistic: one reduces the effect of the other

20. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Potency  Pharmacology: Potency refers to the relative amount of drug required to produce the desired response.  Toxicology: The potency of a toxic chemical refers to the relative amount it takes to elicit a toxic effect compared with other chemicals.

21. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Biological Monitoring  Pharmacology: Biological monitoring is done for some drugs.  Toxicology: Biological monitoring is done for some toxic exposures.

22. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. The Regulatory Process  The regulatory process for approval to sell a medication includes several stages of testing on animals and humans.  The regulatory process for hazardous chemicals that are not food, drug, cosmetic, or pesticide in nature does not require any original testing for human health risks.

23. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Resources for Further Information  General environmental health (with links): www.enviRN.umaryland.edu www.enviRN.umaryland.edu  Toxicology: www.sis.nlm.nih.gov (“toxicology tutor”)www.sis.nlm.nih.gov  Mercury: www.epa.gov/mercury, www.atsdr.cdc.gov ( toxicological profiles), www.hcwh.orgwww.epa.gov/mercury www.atsdr.cdc.gov www.hcwh.org  Effects in children: www.cehn.orgwww.cehn.org  Lead: www.aeclp.org, www.atsdr.cdc.gov ( toxicological profiles)www.aeclp.orgwww.atsdr.cdc.gov

24. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Resources, continued  Nitrate/nitrite: www.epa.gov/safewater, www.ianr.unl.edu (search: nitrate and drinking water)www.epa.gov/safewater www.ianr.unl.edu  Cancer: www.niehs.nih.gov ( National Toxicology Program Report on Carcinogens), www.epa.gov/children ( childhood cancer), S. Steingraber: Living Downstreamwww.niehs.nih.gov www.epa.gov/children

25. Copyright © 2002 University of Maryland School of Nursing. All rights reserved. Resources, continued  Neurological effects: www.igc.org/psr (In Harm’s Way), www.epa.gov/childrenwww.igc.org/psrwww.epa.gov/children ( developmental and neurological problems)  Interactions: www.sis.nlm.nih.gov (“toxicology tutor’); McCauley, L.A. 1998. Chemical Mixtures in the Workplace. AAOHN Journal 46(1):29- 40.www.sis.nlm.nih.gov